Patient Reimbursement Coordinator (Enteral)

This position performs initial patient financial and insurance verification and follow-up. Serves as communication liaison between team members, third party payers, patients, and billing for all financial arrangements. Works closely with referral sources and patients regarding their financial responsibilities. Is also responsible for document management of patient information and ensuring that the claims produced for billing are accurate.

This position offers the option to work hybrid after completion of onsite training. We have a competitive benefit package including excellent PTO! This role requires a hybrid schedule of one day per quarter.

Starting pay: $49,060 annually - Based off of experience.

Technical Responsibilities:

• Performs initial insurance verification and authorization for patient referrals in a timely and effective manner.
• Communicates effectively with referral sources regarding patient financial responsibilities and insurance coverage for nutrition services.
• Communicates with patients regarding financial responsibility both verbally and in writing.
• Performs price negotiations, when applicable, in the best interest of the patient with respect to UWHCD business (including self-pay arrangements), seeking management approval when applicable.
• Maintains knowledge of reimbursement principles and pricing parameters.
• Understands Medicare coverage principles and requirements for covered and non-covered therapies.
• Understands coverage principles and requirements for Wisconsin Medicaid.
• Understands formula and related DME and supply pricing, as it relates to enteral therapy.
• Verbally communicates patient information (including but not limited to insurance and authorization status) to team members in a timely manner.
• Promptly documents all patient information including insurance and authorization information in accordance with company policy and procedures.
• Remains up to date on contract, network, and fee schedule information.
• Obtains authorization extensions on existing patients in a timely and accurate manner.
• Performs ongoing verification of patient insurance, as needed.
• Collaborates effectively with Reimbursement to troubleshoot patient specific A/R issues.
• Performs critical evaluation of vended patient cases and keeps management apprised of any trends or issues, as applicable.
• Serves as a back-up support to the enteral POC in managing supply orders and problem-solving delivery challenges.
• Performs on-call duties as assigned.
• Other duties as assigned.

Benefits Include:

• Health, Dental, and Vision coverage - Competitive premiums!
• 401K matching - we match 100% on the first 3% you contribute and then match 50% on the next 2% you contribute!
• Employee Assistance Program - A great resource when facing different situations in life! Confidential!
• PTO - Generous PTO! 10.46 hours accrued biweekly for a fulltime position (80 hours per pay period)
• Flex Spending Account
• Dependent Care
• Short Term Disability - Employer Paid!
• Long Term Disability - Employer Paid!
• Basic Life Insurance & AD&D - Employer Paid!
• Voluntary Life Insurance
• Benefits take effect the first day of the following month you are hired! 401k eligibility starts one month after all other benefits!

UW Health Care Direct has been an affiliate of UW Health since 1994. In July of 2020 UW Health Care Direct (formerly known as Chartwell Midwest Wisconsin) officially consolidated all community- based home health services to Chartwell from UW Health and Unity Point Health leading to the establishment of UW Health Care Direct. UW Health Care Direct is dedicated to providing home health care services in the Dane County area, ensuring the highest quality of care for the community.

Mission Statement: As healthcare providers, we expect to be the best at what we do and do what is right every time. We hold ourselves accountable to safety, service, and compassion. Through these values, we strive to make a difference in the lives of our patients and employees.

Click on the link below to learn more about us and view our opportunities!

UW Health Care Direct - UW Health - Remarkable Careers